Methods for Novel Drug Discovery, Treatment And Selective Targeting for Gefitinib-Resistant Non-Small-Cell Lung Cancer Harboring T790M Mutation

ABSTRACT

The present invention relates to methods for novel drug discovery, treatment and selective targeting for Gefitinib-resistant non-small-cell lung cancer (NSCLC) harboring an additional mutation, in particular, to the discovery of a drug candidate or agent identified by the presently claimed method for use in treating and selective targeting Gefitinib-resistant NSCLC harboring T790M mutation.

COPYRIGHT NOTICE

A portion of the disclosure of this patent document contains material, which is subject to copyright protection. The copyright owner has no objection to the facsimile reproduction by anyone of the patent document or the patent disclosure, as it appears in the Patent and Trademark Office patent file or records, but otherwise reserves all copyright rights whatsoever.

CROSS REFERENCE TO RELATED APPLICATION

Pursuant to 35 U.S.C. §119(e), this is a non-provisional patent application which claims benefit from U.S. provisional patent application Ser. No. 61/982,355 filed Apr. 22, 2014, and the disclosure of which is incorporated herein by reference in its entirety.

TECHNICAL FIELD

The present invention relates to methods for novel drug discovery, treatment and selective targeting for Gefitinib-resistant non-small-cell lung cancer (NSCLC) harboring an additional mutation, in particular, to the discovery of a drug candidate or agent identified by the presently claimed method for use in treating and selective targeting Gefitinib-resistant NSCLC harboring T790M mutation.

BACKGROUND OF THE INVENTION

Lung cancer is the leading cause of cancer deaths globally [1]. Non-small-cell lung cancer (NSCLC) accounts for over 80% of all the histological classified lung cancer cases, and patients are often diagnosed at the advanced stages of the disease, therefore the prognosis of lung cancer remains poor [2]. With the advanced development of DNA sequencing technology, the therapeutic strategy of NSCLC has been modified towards to personalized therapy. Some specific driver genetic mutations have been identified in NSCLC, such as EGFR [3, 4], EML4-ALK fusion gene [5] and ROS fusion gene [6], which directs the development of molecular-targeted drug discovery to target theses mutations. Among those mutations, EGFR mutation is the most frequently observed gene mutation in Eastern Oriental population, especially in subgroup of patients who are non-smoker, female, clinically diagnosed with Adenocarcinoma and early onset. The common activating mutation of EGFR is a substitution mutation of EGFR^(L858R), which makes EGFR constitutively activated even without EGF stimulation, resulting in downstream activation of anti-apoptotic signaling. Gefitinib, which is a tyrosine kinase inhibitor (TKI), can specifically inhibit EGFR as well as its downstream survival signaling pathway [7]. However, despite the initial significant responses to Gefitinib treatment, like other chemotherapeutic agents, patients acquire resistance to Gefitinib ultimately, and the median time to disease progression is just about 12 months [8]. The most common reasons of Gefitinib resistance is the presence of additional EGFR mutation (EGFR^(L858R+T790M)), which accounts for over 49% of all the resistance cases. The additional T790M mutation will provide steric hindrance to TKI due to the bulkiness of Methionine (M), thus the overall pharmaceutical effect of Gefitinib is weakened. Therefore, it is an urgent need to identify EGFR crosstalk pathways and to discover more effective agents as new candidate drugs for Gefitinib-resistant NSCLC patients.

Sanguinarine, a benzophenanthridine alkaloid, can be isolated from Chinese medicinal herb Macleaya cordata or from North American herb sanguinaria canadensis. Macleaya cordata injection has been utilized as clinical application for treating inflammation. As a major constituent, the pharmacological effects of sanguinarine have been widely studied in many fields for a long time, for example, as anti-microbe [9, 10], anti-inflammation [11, 12] and anti-oxidation [13, 14], but not in the field of NSCLC, especially on Gefitinib-resistant NSCLC. It has acquired the FDA approval as an antibacterial or antiplaque agent in toothpastes in 2003 [15]. Using the drug discovery method as disclosed in the present invention demonstrates the cytotoxic potency of sanguinarine and other chemical agent in treating and selectively targeting Gefitinib-resistant NSCLC. In the present invention, methods for treating and selectively targeting a specific Gefitinib-resistant NSCLC which harbors an additional mutation by using sanguinarine and at least one chemical agent will also be disclosed.

SUMMARY OF THE INVENTION

Accordingly, an objective of the present invention is to provide a method for treating and selectively targeting NSCLC harboring T790M mutation on EGFR comprising using a compound and at least a chemical agent which can elevate high level of reaction oxygen species (ROS) to selectively induce cytotoxicity in gefitinib-resistant NSCLC having T790M additional mutation. According to an embodiment of the present invention, five NSCLC cell lines with different EGFR statuses and gefitinib sensitivity are used to examine the cytotoxic potency of sanguinarine and a chemical agent, e.g. H₂O₂. One of the five cell lines, H1975, which contains L858R and T790M double mutation on EGFR is a gefitinib-resistant NSCLC cell line. H1975 cells demonstrate the highest sensitivity to the treatment of sanguinarine among the five cell lines. The IC₅₀ value of H1975 for sanguinarine is much higher than that of another cell line, A549, which contains wild-type of EGFR. Moreover, the increase of ROS induced by sanguinarine through the up-regulation and activation of NOX3 specifically and significantly induces the degradation of EGFR in H1975 cells. Using H₂O₂ or any other agents that can elevate ROS also specifically induces EGFR degradation and apoptosis, indicating that H₂O₂ is a promising chemical agent for treating T790M containing gefitinib-resistant NSCLC. Another factor contributes to the sensitivity of H1975 upon sanguinarine treatment is methionine sulfoxide reductase. Compared with the normal lung epithelial cells, expression of the methionine sulfoxide reductase is at the lowest level in H1975 cells among the five cell lines. Therefore, the increase of ROS induced by sanguinarine is much easier to push H1975 onto the limit of oxidative stress and then induces apoptosis than that in other NSCLC cell lines. The screening method of the present invention can also be used to test other compound or agent in future for specifically treating gefitinib-resistant NSCLC having additional mutation such as T790M.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments of the present invention are described in more detail hereinafter with reference to the drawings, in which:

FIG. 1 is flow cytometry plots depicting ROS content induced by different concentration of sanguinarine in H1975 cells;

FIG. 2 is western blots of different EGFR markers in different cell lines treated with sanguinarine (A), H1975 and A549 cells treated with different concentrations of sanguinarine (B), and H1975 and A549 cells treated with different concentrations of H₂O₂;

FIG. 3 is western blots of different EGFR markers in HEK293 cells transfected with different constructs and treated with sanguinarine (A) and H₂O₂ (B); (A) from left to right: HEK293 cells, HEK293 cells with wild type EGFR, HEK293 cells with L858R mutation on EGFR, HEK293 cells with exon 19 deletion on EGFR, HEK293 cells with double mutation of L858R and T790M on EGFR; (B) left panel: HEK293 cells with wild type EGFR treated with 0, 100, 200 and 300 μM H₂O₂; right panel: HEK293 cells with double mutation of L858R and T790M on EGFR treated with 0, 100, 200 and 300 μM H₂O₂;

FIG. 4 is ESI-MS result of short peptide and oxidized methionine in the peptide treated with different concentrations of H₂O₂: (A) peptide of LIMQL and its oxidized form, LIM(O)QL; (B) is H₂O₂ untreated sample; (C) is sample treated with 10 μM H₂O₂ for 10 min; (D) is sample treated with 20 μM H₂O₂ for 10 min; (E) is sample treated with 40 μM H₂O₂ for 10 min; (F) is sample treated with 80 μM H₂O₂ for 10 min; (G) is sample treated with 100 μM H₂O₂ for 10 min; One of representative data was shown (n=3);

FIG. 5 is a schematic diagram showing how methionine is oxidized or reduced by ROS and reductase in the proposed signaling pathway.

FIG. 6: (A) RNA expression level of NOX 3 compared in cells treated with or without sanguinarine. Results are expressed as mean±S.E.M. The data represent mean±S.E.M. of three independent experiments. (n=3, ***p<0.001); (B) Up-regulation of NOX 3 by sanguinarine on protein level; (C) Degradation of EGFR induced by sanguinarine in H1975 at 24 hrs. One of representative data was shown (n=3); (D) Real-time PCR detected RNA expression level of Msr A in 5 NSCLC cell lines. The expression level of Msr in other 5 cell lines is normalized to that of BEAS-2B. The data represent mean±S.E.M. of three independent experiments (n=3, *p<0.05, **p<0.01, ***p<0.001).

FIG. 7 is schematic diagram of the proposed cell model of H1975 cells in EGFR degradation induced by sanguinarine and H₂O₂.

DETAILED DESCRIPTION OF THE INVENTION

The following description and the corresponding embodiments of the present invention are set forth as preferred examples. It will be apparent to those skilled in the art that modifications, including additions and/or substitutions, may be made without departing from the scope and spirit of the invention. Specific details may be omitted so as not to obscure the invention; however, the disclosure is written to enable one skilled in the art to practice the teachings herein without undue experimentation.

EXAMPLES Example 1 IC₅₀ Values of Sanguinarine Against Five NSCLC Cell Lines

Table 1 shows I_(C50) values of sanguinarine against five NSCLC cell lines. Among the five cell lines, H1975 is the most sensitive cells to sanguinarine treatment, while A549 is the most resistant one. The IC₅₀ value of sanguinarine in H1975 is 3-fold, 8-fold, 5.1-fold and 5.4-fold lower than that of HCC827, A549, H1650 and H2228 respectively, suggesting that sanguinarine is especially more effective in NSCLC cells containing EGFR L858R+T790M double mutation.

TABLE 1 IC₅₀ values of sanguinarine against five NSCLC cell lines. IC₅₀ value (μM) Treatment Treatment Gefitinib Cell lines (24 hrs) (48 hrs) resistance H1975(EGFR^(L858R+T790M)) 0.68 ± 0.24 0.58 ± 0.14 resistance HCC827(EGFR^(L858R))  1.90 ± 0.248 1.055 ± 0.27  sensitive H1650 (EGFR^(Exon19 deletion)) 3.47 ± 1.31 2.64 ± 1.31 resistance H2228 (EML4-ALK) 3.73 ± 1.23 3.08 ± 1.56 resistance A549 (EGFR^(wild-type)) 5.71 ± 1.73 3.83 ± 1.11 resistance

Example 2 Reactive Oxygen Species (ROS) Generation Induced by Sanguinarine in H1975 Cells

ROS generation is an early and essential response to apoptosis induced by sanguinarine. Therefore, according to example 1, H1975 cells are selected as the cell model of NSCLC cells containing EGFR L858R+T790M double mutation to evaluate the efficacy of sanguinarine in induction of ROS generation. Flow cytometry is used to study ROS intensity in H1975 cells treated with 1.25 μM sanguinarine over a time course. In FIG. 1A, ROS generation is induced by sanguinarine starting at 30 minutes of incubation, and gradually increased over the time course. FIG. 1B shows that from 4 hours to 6 hours of sanguinarine treatment, the ROS generation is increased more significantly.

Example 3 Effect of Elevation of ROS Induced by Sanguinarine or H₂O₂ on EGFR Degradation in NSCLC Cells with T790M Mutation

In FIG. 2, expression level of total EGFR, EGFR (pY845) and EGFR (pY1068) in different NSCLC cell lines (H1975, H1650, A594, and HCC827) treated with different concentrations of sanguinarine (FIG. 2B) and H₂O₂ (FIG. 2C) is demonstrated. FIG. 2A is a control. Among the four cell lines, only H1975 cells have additional T790M mutation on EGFR. At 1.25 μM sanguinarine, expression level of total EGFR, pY845 EGFR and pY1068 EGFR is all reduced in H1975 cells; whereas no significant reduction in expression level of all markers by sanguinarine is observed in A594 cells. Compared with sanguinarine, effect of H₂O₂ on suppression of these markers in H1975 cells is relatively less significant. However, at 25 μM H₂O₂, expression level of total EGFR and pY845 EGFR appears to be slightly reduced in H1975 cells; whereas no significant change in the level of all markers in A594 cells by H₂O₂ is observed. This example reveals that both sanguinarine and H₂O₂ can degrade EGFR but their cytotoxic potency are different. Sanguinarine is more potent than H₂O₂ in terms of the EGFR degradation in NSCLC cells having T790M mutation and the concentration used. The EGFR degradation is also specific in NSCLC cells having T790M mutation by using sanguinarine or H₂O₂.

Example 4 Effect of Sanguinarine or H₂O₂ on EGFR T790M Transfected Cells

HEK293 cells are used in this example as cell model to be transfected with different constructs of EGFR (wild-type, L858R mutation, Exon 19 deletion, L858R+T790M double mutation). In FIG. 3A, 3 μM saguinarine is added into the HEK293 transfected with different EGFR constructs. Expression level of total EGFR in different samples of HEK293 cells is shown in western blot, where the HEK293 cells transfected with EGFR construct having double mutation (L858R and T790M) (SEQ. ID NO. 1/GenBank Accession number of DNA is NM 005228) shows significant reduction in total EGFR level, while the rest of the samples do not show any significant reduction in total EGFR level. FIG. 3B shows expression level of total EGFR in different HEK293 cell samples treated with different concentrations of H₂O₂. In HEK293 cells transfected with construct of EGFR having double mutation, sample treated with 200 μM H₂O₂ shows significant reduction in total EGFR level; sample treated with 300 μM H₂O₂ even shows a more significant reduction in total EGFR level. This example reveals that both Sanguinarine and ROS elevating agents such as H₂O2 can specifically induce EGFR degradation not only in cell line but also in EGFR T790M transfectant, indicating that the ROS-induced EGFR degradation effect is a new mechanism related to the unique character of T790M mutation on EGFR rather than individual cell line character.

Example 5 Oxidization of Methionine in Short EGFR Peptide by H₂O₂ in a Dose- and Time-Dependent Manner

The methionine amino acid of a short EGFR peptide containing the T790M mutation could be easily oxidized in a dose-dependent manner under oxidative stress condition. This example shows that the main reason for EGFR protein degradation is due to specific oxidation on methionine amino acid residue at peptide position 790, eventually leading to EGFR protein damage, degradation and apoptosis specifically happening in T790M-containing NSCLC cells or host cells transfected with T790M construct. A peptide equivalent to the amino acid sequence position from 788 to 792 of EGFR in wild-type (LITQL) and T790M mutant (LIMQL) of EGFR (Sequence acquired from Pubmed database; SEQ. ID. NO. 2/GenBank Accession number of amino acid is NP 005219) is synthesized and both of them are subject to mass spectrometry. In FIG. 4A, ESI-MS detects the standard peptide of LIMQL and oxidized form of the peptide (LIM(O)QL). They are used as standard of the MS pattern of the un-oxidized form of methionine (“M”) and the oxidized form methionine (“M(O)”) for the EGFR short peptide. FIG. 4B-G are ESI-MS results of oxidized methionine in peptide treated with different concentrations of H₂O₂: FIG. 4B is for H₂O₂ untreated sample; FIG. 4C is for sample treated with 10 μM H₂O₂ for 10 min; FIG. 4D is for sample treated with 20 μM H₂O₂ for 10 min; FIG. 4E is for sample treated with 40 μM H₂O₂ for 10 min; FIG. 4F is for sample treated with 80 μM H₂O₂ for 10 min; FIG. 4G is for sample treated with 100 μM H₂O₂ for 10 min. One of representative data is shown (n=3). The result in FIG. 4 indicates that the short EGFR peptide containing un-oxidized form T790M can be oxidized by ROS in a time- and dose-dependent manner.

Example 6 Effect of Sanguinarine on RNA and Protein Expression of NOX 3 in H1975 Cells

In this example, the results demonstrate that sanguinarine increases the expression of NOX 3 in both RNA and protein level in H1975 cells. FIG. 6A shows the RNA expression level of NOX 3 in cells treated with and without sanguinarine. The fold change of treated group is normalized to untreated group. Results are expressed as mean±S.E.M. The data represent mean±S.E.M. of three independent experiments. (n=3, ***p<0.001). In FIG. 6B, the up-regulation of NOX 3 by sanguinarine is also confirmed on protein level, which is corresponding to the degradation of EGFR. The flow cytometry result in FIG. 6C supports that DPI blocks the apoptosis and the degradation of EGFR induced by sanguinarine in H1975 at 24 hrs. One of representative data is shown (n=3). FIG. 6D uses real-time PCR to detect the RNA expression level of Msr A in five NSCLC cell lines. The expression level of Msr in other 5 cell lines is normalized to that of BEAS-2B cell line. The data represent mean±S.E.M. of three independent experiments (n=3, *p<0.05, **p<0.01, ***p<0.001). The result in this example supports that NADPH oxidase and methionine sulfoxide reductase are key enzymes involved in the ROS generation induced by reactive oxygen species stimulation in gefitinib-resistant NSCLC. Schematic diagram of how methionine (Met) is oxidized by NADPH oxidase (ROS) and reduced by methionine sulfoxide reductase is shown in FIG. 5. FIG. 7 is a cell model further illustrating how sanguinarine and H₂O₂ act on the signaling pathway of inducing EGFR degradation in H1975 cells, and thereby leading to apoptosis of the cells. H1975 cells contain L858R and T790M double mutation on EGFR which can auto-activate EGFR without the stimulation of EGF and thus continually activates NOX family and generates high basal ROS level. Like A549, ROS produced by NOX oxidizes (OX) the cysteine (Cys) residue at position 797 of EGFR and further activates EGFR to promote cell proliferation. Besides oxidation at Cysteine 797, Methionine (Met) residue at position 790 site of EGFR is also easily to be oxidized. Msr A, which is the intracellular reduction enzyme, can reduce the oxidized Met form back to original reduced form, is lowly expressed in H1975. However, due to mild basal oxidation, it can still reduce Met back to reduce from. However, under high basal ROS level and low basal anti-oxidation capacity of Met, treatment with sanguinarine can push the intracellular ROS level beyond the upper limit, and Msr A is insufficient to reverse the excessive oxidation on Met. As a result, EGFR in H1975 is over-oxidized and subsequently damaged. The degradation of EGFR results in oncogene shock to EGFR-dependent H1975 cells and finally apoptosis is induced.

INDUSTRIAL APPLICABILITY

The presently claimed methods are useful in drug discovery and design of treatment strategy for selective targeting Gefitinib-resistant non-small-cell lung cancer harboring T790M mutation by using agent elevating reactive oxygen species to induce methionine oxidation. The presently disclosed sanguinarine and other agent that release high ROS exerts specific remarkable cytotoxic effect on killing Gefitinib-resistant NSCLC cell. The ability of sanguinarine and other agents in inducing high ROS levels can effectively and specifically trigger the degradation of EGFR in T790M containing NSCLC, resulting in apoptosis. The low basal expression level of methionine reductase in T790M containing NSCLC cell lines suggests that sanguinarine can be used as cytotoxic agent to kill T790M-containing NSCLC by causing oxidation of methionine, which can be developed into a methionine reductase inhibitor to enhance the damage to T790M EGFR protein to basal oxidase stress. Also, NOX3 are upregulated by sanguinarine, indicating that NOX3 activator can be used as new drug to treat T790M containing NSCLC patients by elevation of ROS. Taken together, the present invention indicates that sanguinarine and any other agents that release high level of ROS can be used for further investigation as new class of EGFR inhibitor by directing oxidized the sulphur atom containing amino acid residues of EGFR, such as methionine and potentially on cysteine, which are the only two essential amino acids containing S atom that could be oxidized, resulting in EGFR protein damage. These agents can be used to act against Gefitinib-resistant NSCLC patients, especially for the group of patients with EGFRL858R+T790M mutation which represents 49% of all Gefitinib resistance cases. This novel strategy to block EGFR growth signaling pathway in NSCLC based on protein oxidation method is completely new idea as the currently clinically available inhibitors or inhibitors undergoing clinical trials are based on inhibition of EGFR phosphorylation rather than specifically inducing methionine oxidation and EGFR degradation.

The foregoing description of the present invention has been provided for the purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise forms disclosed. Many modifications and variations will be apparent to the practitioner skilled in the art.

The embodiments are chosen and described in order to best explain the principles of the invention and its practical application, thereby enabling others skilled in the art to understand the invention for various embodiments and with various modifications that are suited to the particular use contemplated. It is intended that the scope of the invention be defined by the appended claims and their equivalence.

REFERENCE

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The foregoing references are also incorporated herein by reference in their entirety. 

What is claimed is:
 1. A method for selectively targeting and treating Gefitinib-resistant non-small-cell lung cancer harboring a mutation, said method comprising administrating to a subject with sanguinarine and at least one chemical agent capable of elevating level of reaction oxygen species in cancer cells of said cancer.
 2. The method of claim 1, wherein said mutation is T790M mutation on epidermal growth factor receptor.
 3. The method of claim 1, wherein said chemical agent is hydrogen peroxide.
 4. The method of claim 1, wherein said sanguinarine and at least one chemical agent capable of elevating level of reaction oxygen species triggers degradation of epidermal growth factor receptor, leading to apoptosis of said cancer cells.
 5. The method of claim 1, wherein said sanguinarine is a methionine reductase inhibitor.
 6. The method of claim 1, wherein said sanguinarine is a NOX3 activator.
 7. The method of claim 1, wherein said epidermal growth factor receptor with the T790M mutation has an amino acid sequence of SEQ. ID. NO.
 2. 8. A method for screening compound or chemical agent for selectively targeting and treating Gefitinib-resistant non-small-cell lung cancer harboring a mutation comprising using Gefitinib-resistant non-small-cell lung cancer cells harboring said mutation or transfecting into normal cells with an expression vector containing a construct of epidermal growth factor receptor having said mutation; applying an effective amount of said compound or chemical agent to either said cancer cells or normal cells transfected with said expression vector; and measuring expression level of different markers in order to demonstrate degradation of epidermal growth factor receptor, thereby leading to apoptosis of said cancer.
 9. The method of claim 8, wherein said compound is sanguinarine.
 10. The method of claim 8, wherein said mutation is T790M mutation on epidermal growth factor receptor.
 11. The method of claim 8, wherein said chemical agent is hydrogen peroxide.
 12. The method of claim 8, wherein said compound or chemical agent is capable of elevating level of reaction oxygen species triggering degradation of epidermal growth factor receptor, leading to apoptosis of said cancer cells.
 13. The method of claim 8, wherein said markers comprise reaction oxygen species, epidermal growth factor receptor, and NOX
 3. 14. The method of claim 8, wherein said cancer cells are H1975 cells.
 15. The method of claim 8, wherein said normal cells are HEK293 cells.
 16. The method of claim 8, wherein said construct of epidermal growth factor receptor having said mutation has a coding sequence of SEQ. ID NO.
 1. 17. The method of claim 10, wherein said epidermal growth factor receptor with the T790M mutation has an amino acid sequence of SEQ. ID. NO.
 2. 18. The method of claim 8, wherein said compound is a methionine reductase inhibitor.
 19. The method of claim 8, wherein said compound is a NOX3 activator. 